GIFT   OF 


State  Boanfor  C.haritie$  aji^,  Corrections 


vy  ~i         f\  r\    • 

'lules  and  Regulations 

Governing  Maternity  Hospitals  and  Homes 


Compiled  and  published  by  the 

California  State  Board  of  Charities 
and  Corrections 

995  Market  Street,  San  Francisco 
1018  Pacific  Finance  Building,  Los  Angeles 


:••• 


September,  1922 


California  State  Printing  Office 
Sacramento,  California 


21117 


LAW     GOVERNING     L!-GJENSK    AND    SUPHR-. 

\  VISION  OF  MATEKNIT.Y  HGSF!TAL.S.  MND 
HOMES  BY  THE  CALIFORNIA  STATE 
BOARD  OF  CHARITIES  AND  COR- 
RECTIONS. 

CHAPTER  69,   STATUTES   1913. 

An  act  to  provide  for  the  licensing,  inspecting 
and  regulating  of  maternity  hospitals  or 
lying-in  asylums,  and  institutions,  boarding 
houses  and  homes  for  the  reception  and  care 
of  children,  by  the  state  board  of  charities 
and  corrections,  and  providing  a  penalty  for 
the  violation  of  the  provisions  of  this  act. 

[Approved  April  23,   1913.     In  effect  August  10, 
1913.] 

The  people  of  the  State  of  California  do  enact  as 
follows: 

SECTION  1.  No  person,  association,  or  cor- 
poration shall  hereafter  maintain  or  conduct  in 
this  state  any  maternity  hospital  or  lying-in 
asylum  where  females  may  be  received,  cared 
for  or  treated  during  pregnancy,  or  during  or 
after  delivery ;  or  any  institution,  boarding 
house,  home  or  other  place  conducted  as  a  place 
for  the  reception  and  care  of  children,  without 
first  obtaining  a  license  or  permit  therefor,  in 
writing,  from  the  state  board  of  charities  and 
corrections,  such  permit  or  license  once  issued 
to  continue  until  revoked  for  cause  after  a 
hearing. 

>SBC.  2.  The  state  board  of  charities  and  cor- 
rections is  hereby  authorized  to  issue  licenses 
or  permits  to  persons  or  associations  to  conduct 
maternity  hospitals,  lying-in  asylums,  or  homes 
for  children,  as  provided  in  section  one  of  this 
act,  and  to  prescribe  the  conditions  upon  which 
such  licenses  or  permits  shall  be  granted,  and 
such  rules  and  regulations  as  it  may  deem  best 
for  the  government  and  regulation  of  maternity 
hospitals,  lying-in  asylums  and  institutions, 
boarding  houses,  or  homes  for  the  reception  and 
care  of  children,  and  said  board  is  further 
authorized,  by  one  or  more  of  its  members,  sec- 
retary, or  duly  authorized  representative,  to 

3 

a-21117 


and  t0^!"*!  w*T>$n  *the  conditions  prevail-! 
In.*; 1 11    SIH^*I    fiijiti<i»£i£ns. 

""*  3.  Any  persSn  whp  maintains  or  con-( 
"nTjig  or  conducting  as 
9  maternity  hospital/ 
^tistitution,  boarding 
house,  home  or  other  place  conducted  as  a 
pi,  i  ro  for  the  reception  and  care  of  children,  or 
who  keeps  at  any  such  place  any  child  under  the 
age  of  twelve  years,  not  his  relative,  apprentice 
or  ward,  without  first  having  obtained  a  license 
or  permit  therefor  in  writing,  as  provided  in 
section  one  of  this  act,  shall  be  punished  upon 
conviction  by  imprisonment  in  the  county  jail 
for  not  more  than  one  year,  or  by  a  fine  not  to 
exceed  five  hundred  dollars,  or  both  a  fine  and 
imprisonment  may  be  imposed  at  the  discretion 
of  the  court. 


RULES  AND  REGULATIONS  FOR 
THE  GOVERNMENT  OF  MATER- 
NITY HOSPITALS  AND  HOMES. 

In   accordance  with  Chapter  CO,   Statutes  11)13. 

Definitions. 

Any  place  into  which  women  are  received 
to  be  cared  for  before,  during1  or  after 
parturition  shall  be  considered  as  a  maternity 
hospital  or  home. 

Institutions  caring  for  maternity  patients  are 
classified  as  follows,  according  to  equipment : 

Class  A.  Separate  class  A  building  with  com- 
plete equipment  caring  for  maternity  patients 
only. 

Class  B.  Hospital  with  maternity  depart- 
ment with  fully  equipped  delivery  room  and 
nursery. 

Class  C.  General  hospital  with  either  deliv- 
ery room  or  nursery  and  general  hospital  using 
the  operating  room  for  delivery. 

For  rules  and  regulations  for  Class  A,  B  and 
C  maternity  hospitals,  see  page  C. 

Class  D.     Private  homes. 

For  rules  and  regulations  for  Class  D  private 
maternity  homes,  see  page  13. 


RULES     AND      REGULATIONS     GOVERNING 
'-    '.   *  ;•    /-MAVK^RNITY/HpSLPITALS. 

'(Classes*  A,  B  and  C.) 


Granting    and    revoking    license. 

1.  All  maternity  hospitals  and  homes  are  re- 
quired,  in  accordance  with   Section   3,   Chapter 
69,   Statutes  1913,  to  secure  the  license  of  the 
State  Board  of  Charities  and  Corrections,  and 
to  conform  to  the  standards  set  by  that  board. 

2.  Application   for   license   must  be   made   on 
blanks  furnished  by  the  State  Board  of  Chari- 
ties and  Corrections. 

3.  Every  applicant  must  have  the  approval  of 
the  local  board  of  health  or  health  officer. 

4.  Every  licensee  shall   post  his  license  in   a 
conspicuous  place. 

5.  Any    change    of    ownership,    management, 
location  or  name  shall  be  promptly  reported  to 
the   State   Board   of  Charities   and  Corrections. 
When  any  such  change  is  contemplated  an  appli- 
cation   for   a    new    license    shall    be    made.     In 
such   instance   the  new   license  may  be  granted 
on  surrender  of  the  license  held. 

6.  No  greater  number  of  women  and  infants 
shall  be  cared  for  at  one  time  on  such  premises 
than  is  authorized  by  the  license  and  no  women 
or  infants  shall  be  kept  in  a  building  or  place 
not  designated  in  the  license. 

Physical   equipment. 

1.  All  rooms  and  wards  occupied  by  patients 
shall   be   outside   rooms   and   the   window   space 
shall  not  be  less  than  one-fifth  of  the  floor  space. 

2.  The  rooms  and  wards  shall  be  of  sufficient 
size  to  allow  not  less  than  800  cu.  ft.  of  air  space 
and   100   sq.    ft.   of   floor   space   for  each-  adult 
patient   and  250  cu.   ft.   of   air  space  for   each 
infant  therein.     Ventilation  shall  conform  with 
state  housing  laws. 


3.  All  plumbing,  drainage  and  other  arrange- 
ments for  the  disposal  of  excreta  and  household 
waste  shall  be  in  accordance  with  the  rules  and 
regulations  of   the   State   Board  of  Health   and 
local  health  ordinances. 

4.  Toilets  and  hoppers  shall  be  properly  and 
adequately  ventilated  to  the  external  air. 

5.  In  order  that  the  heating  of  all  rooms  shall 
be  safe  and  adequate  no  gas  stove  shall  be  used 
which  is  not  directly  connected  with  an  outside 
flue  and  all  gas  connections  should  be  of  metal 
piping. 

6.  Fire   protection   shall   be  according  to   the 
rules  and   regulations  of  the  local  fire  commis- 
sion or  city  ordinance  and  the  rules  and  regula- 
tions   of    the    State    Board    of    Charities    and 
Corrections.     These  standards  will  be  furnished 
with  the  application. 

7.  Provision    for   isolation   of   contagious   dis- 
eases shall  be  made. 

8.  There    shall    be    sanitary    equipment    for 
thorough  bathing  of  patients  and  infants. 

9.  An  adequate  supply  of  clean'  bedding,  body 
linen  and  towels  shall  be  kept  on  hand  at  all 
times. 

Bed  pan  sterilizers  are  recommended  for  hos- 
pitals. A  separate  bed  pan  marked  for  use  of 
individual  patients  is  strongly  advocated. 

Delivery  room. 

1.  A  delivery  room  shall  be  provided ;  it  must 
be    ready   at   all    times   and   used    for   no   other 
purpose. 

2.  The   floors,   walls   and   ceiling  shall   be   of 
such    material    as    will    permit   of   being   easily 
washed.     Provision  must  be  made  for  steriliza- 
tion of  water,  basins,  instruments  and  dressings. 
There  shall   be   running  water  with  a  properly 
trapped  and  vented  basin. 

3.  The  delivery  room  shall  be  furnished  with 
a  delivery  table  or  bed,   instrument  table,  irri- 
gating  apparatus,   basins   and   pitchers.     There 
shall   be  an   ample  supply   of  sterile  linen  and 

7 


.     Drugs     ordinarily     needed     for     use 

shall  In-  kept   in   i he  nn;in  at  all  times. 

I.  Tw.i  infants'  tulis  shall  be  provided  for 
resnsritation  in  delivery  room. 

."».  Kvery  infant  shall  be  marked  for  identifi- 
caiii  n  before  il  is  taken  from  delivery  room. 

Nursery. 

1.  A   separate   room   for   a   nursery   shall   be 
provided. 

2.  Infants'  cribs  or  baskets   shall   have   firm, 
clean   mattresses,   covered  with   rubber  sheeting 
and  xvashaltlc  pads.     Clean  woolen  blankets  shall 
IK-  used.     There  shall  be  a  separate  bed  for  each 
infant. 

3.  It    is    recommended    that    the    nursery    be 
provided    with    stationary    bathing    facilities,    a 
properly    protected    dressing    table    and    correct 


4.  The  nursery  shall  be  heated  and  ventilated. 
VA  wall  thermometer  must  be  provided  in  order 
to  be  sure  that  an  even  temperature  is  main- 
tained. 

."i.  A  covered  container  for  soiled  linen  shall 
be  provided. 

G.  A  dressing  tray  shall  be  set  up  at  all  times. 
The  following  articles  are  recommended  in 
dressing  and  caring  for  infants :  Sterile  gauze, 
absorbent  cotton,  medium  and  small  safety  pins, 
bottle  of  alcohol,  a  bar  of  pure  mild  soap,  a 
proper  lubricant  (albolene  or  olive  oil),  boric 
acid  solution,  pure  powder,  abdominal  binder  for 
infant. 

7.  Bottles     and     nipples     shall     be     properly 
sterilized  after  each  use. 

8.  A  minimum  of  one  doz-en  diapers  per  child 
sli a  11   be   provided   for  each   24   hours.     Freshly 
laundered  diapers  only  shall  be  used. 

9.  If  hot  water  bags  are  ordered  by  physician, 
they  must  be  covered  with  a  flannel  bag  before 
being  placed  in  the  crib,  and  must  not  come  in 
direct  contact  with  the  baby's  body. 


Care  of  patients. 

1.  Immediately  upon  the  beginning  of  labor,  a 
loyally  qualified    physician   shall   be  notified  and 
shall  be  present  and  in  attendance  at  the  time  of 
birth. 

2.  The  eyes  of  all  new  born   infants  shall  be 
treated   immediately  after  birth   with  a  one  per 
cent  solution  of  nitrate  of  silver,  two  drops  in 
each   eye,   or  with   other  approved  solution  and 
during   the   first   few   days   cleansed   daily   with 
saturated  boric  acid  solution.     Ampoules  of  ni- 
trate of  silver  solution  may  be  obtained  free  of 
charge   by  charitable   institutions  upon  applica- 
tion to  State  Board  of  Health,  713  Wells  Fargo 
Building,  San  Francisco,  or  821  Pacific  Finance 
Building,  Los  Angeles. 

3.  Attention   is   called   to   Chapter   724,    Stat- 
utes 1915,  which  requires  the  reporting  of  red- 
dened   or    inflamed    eyes    of    an    infant,    within 
two  weeks  after  birth,  to  the  local  health  officer 
of  the  county  or  municipality  within  which  the 
mother  of  such  infant  resides. 

4.  If  the  child  is  kept  in  the  hospital  and  is 
not  breast  fed  by  the  mother,   the  feeding  and 
selection  of  food,  shall  be  under  the  direction  of 
a   registered  physician.     If  a   wet-nurse  is  pro- 
vided,    she    shall     meet    the    approval     of    the 
physician.     Whenever  advisable  the  mother  shall 
be  urged  to  nurse  her  child. 

5.  Each    maternity    hospital    shall    employ    at 
least  one  graduate  nurse. 

6.  Any   patients  afflicted   with   a   venereal   or 
other    communicable    disease    shall    be    properly 
isolated   in   a   separate   room   and   all   necessary 
precautions  taken  to  prevent  the  spread  of  such 
disease  to  other  persons.  • 

Disposal  of  child. 

1.  Attention  is  called  to  section  224  of  the 
Civil  Code  in  accordance  with  which  a  child  not 
retained  by  the  mother  must  be  legally 
relinquished  before  it  can  be  adopted.  This 

9 


relinquishment  must  be  expressed  in  writing, 
signed  and  acknowledged  before  an  officer 
authorized  to  take  acknowledgments,  or  before 
the  secretary  of  one  of  the  organizations  men- 
tioned below.  Before  adoption  can  take  place  a 
copy  of  the  relinquishment  must  be  filed  with 
the  State  Board  of  Charities  and  Corrections. 

2.  Attention  is  called  to  Chapter  569,  Stat- 
utes 1911,  providing  for  the  supervision  and 
control  by  the  State  Board  of  Charities  and 
Corrections  of  the  placing  of  dependent  children 
into  homes,  which  makes  it  a  misdemeanor  for 
any  person,  association  or  society  to  engage  in 
the  work  of  placing  children  into  homes  without 
a  license  from  the  State  Board  of  Charities  and 
Corrections.  The  following  agencies  have  been 
licensed  to  place  dependent  children  into  homes 
and  to  arrange  for  adoption  : 

Berkeley  Welfare  Society,  2120  Grove  street, 
Berkeley. 

Children's  Home  Society,  919  E.  Twenty-fifth 
street,  Los  Angeles. 

Children's  Home  Society  (Branch),  3491 
Sixty-sixth  street,  Oakland. 

Catholic  Ladies'  Aid  Society,  City  Hall,  Oak- 
land. 

Oakland  Associated  Charities,  City  Hall,  Oak- 
land. 

Little  Children's  Aid>,  995  Market  street,  San 
Francisco. 

^  Children's  Agency  of  the  Associated  Chari- 
ties, 1500  Jackson  street,  San  Francisco. 

Eureka  Benevolent  Society,  436  O'Farrell 
street,  San  Francisco. 

Native  Sons'  and  Daughters'  Central  Com- 
mittee on  Homeless  Children,  955  Phelan  Build- 
ing San  Francisco,  322  N.  Van  Ness  avenue,  Los 
Angeles. 

3.  Each   licensee    shall    use   due   diligence   to 
prevent  the  abandonment  of  children,  which  is, 
according  to  section  270-271   and  271-a   of  the 
Penal  Code,  a  penal  offense. 

4.  A  licensee  shall  not  be  permitted  to  adver- 
tise that  he  will  procure  the  adoption  of  children 

10 


or  to  hold  out  inducements  to  mothers  to  part 
with  their  offspring. 

5.  Maternity  hospitals  shall  report  on  the 
usual  report  forms  to  the  State  Board  of  Chari- 
ties and  Corrections  within  twenty-four  hours 
the  name  and  address  of  any  person  other  than 
a  parent  or  relative,  by  blood  or  marriage,  or  . 
the  name  and  address  of  the  organization  or 
institution  into  whose  custody  a  child  is  given 
on  discharge  from  the  licensed  premises. 

Records. 

1.  Every  licensee  must  have  a  register 
wherein  he  shall  enter  the  name  and  address  of 
every  maternity  patient,  the  date  of  admission 
and  discharge  of  every  patient,  the  name  and 
sex  of  every  child  born  or  boarded  on  the 
premises,  the  date  of  every  birth,  the  legitimacy 
or  illegitimacy  of  every  child,  the  name  and  resi- 
dence of  the  father,  the  date  of  removal  of  the 
child,  the  name  and  address  of  the  person  taking 
it  away,  and,  if  relinquished  by  the  mother,  the 
date  of  relinquishment,  the  name  and  address 
of  the  person  to  whom  the  child  is  relinquished, 
and  the  reasons  therefor ;  and  if  adopted,  the 
date  of  adoption,  the  name  of  the  person  sign- 
ing the  consent  to  adoption,  and  the  name  and 
address  of  the  person  adopting  the  child. 
Every  admission,  discharge,  birth,  death,  relin- 
quishment or  adoption  must  be  recorded  in  the 
register  within  twenty-four  hours  after  its 
occurrence.* 


*The  State  Board  of  Charities  and  Corrections 
does  not  furnish  the  maternity  hospital  regis- 
ter, it  merely  prescribes  the  form.  A  book  may 
be  obtained  from  A.  Carlisle  and  Co.,  251  Bush 
street,  Schwabacher,  Prey  and  Company,  611 
Market  street,  or  H.  S.  Crocker,  565  Market 
street,  San  Francisco,  and  from  Morris  and  Le 
Leviere,  218  New  High  street,  Dos  Angeles. 
These  forms  are  kept  in  duplicate,  the  per- 
forated sheets  to  be  removed  and  sent  to  the 
office  of  the  State  Board  of  Charities  and  Cor- 
rections, as  the  semi-annual  report.  The  car- 
bon copy  remains  permanently  bound  for  the 
hospital  record. 

11 


2.  A  somi-annual  report,  which  shall  be  an 
exact  transcript  of  this  register,  shall  be  made 
!<>  tli.-  SIMM-  Px.anl  of  Charities  and  Corrections, 
!!!)."»  Market  street,  San  Francisco,  January  1 
;nnl  July  1  of  each  year. 

.">.  A  detailed  medical  record  of  mothers'  and 
infants'  physical  condition  shall  be  maintained. 
<  Sample  forms  provided  by  State  Board  of 
Charities  and  Corrections,  upon  request.) 

4.  It    is    recommended    that    all    orders    from 
physicians    regarding    mothers    and    infants    be 
written  in  ink  on  charts  OT  in  order  book. 

5.  It  is  recommended  that  attending  physician 
examine  mother  and  infant  on  day  of  discharge 
and  attach  signature  to  statement  of  findings. 

().  All  births  and  deaths  must  be  reported 
promptly  to  the  local  authorities  by  the  attend- 
in  -  physician.  (See  Political  Code,  Section  3077, 
Chapter  378,  Statutes  1915.) 

Inspections. 

The  proprietor  or  person  in  charge  of  a 
maternity  hospital  shall  give  the  inspectors  of 
the  State  Board  of  Charities  and  Corrections  all  • 
information  required  and  shall  afford  them  every 
facility  fcr  examining  the  records,  inspecting  the 
premises,  and  seeing  the  inmates,  and  inquire 
into  all  matters  concerning  such  hospital  or 
house  and  the  inmates  thereof. 


12 


RULES      AND      REGULATIONS      GOVERNING 
MATERNITY    HOMES. 

(Class  D.) 


No  private  maternity  home  shall  receive  at 
any  one  time  more  than  three  patients.  No 
other  type  of  patient  shall  be  eared  for  in  this 
home.  Delivery  shall  take  place  in  a  room  with 
washable  walls,  ceilings  and  floors. 

Granting    and    revoking    license. 

1.  All   maternity   homes   are   required,   in   ac- 
cordance with   Section  3,   Chapter  60,   Statutes 
1913,  to  secure  the  license  of  the  State  Board  of 
Charities    and    Corrections,    and   to   conform   to 
the  standards  set  by  the  board. 

2.  Application   for   license   must  be    made   on 
blanks  furnished  by  the  State  Board  of  Chari- 
ties and  Corrections. 

3.  Every  applicant  must  have  the  approval  of 
the  local  board  of  health  or  health  officer. 

4.  Every  licensee  shall   post  his   license  in  a 
conspicuous  place. 

5.  Any    change    of    ownership,    management, 
location  or  name  shall  be  promptly  reported  to 
the   State   Board   of   Charities   and  Corrections. 
When  any  such  change  is  contemplated  an  appli- 
cation   for    a    new    license    shall    be    made.     In 
such   instance   the  new   license  may  be  granted 
on  surrender  of  the  license  held. 

6.  No  greater  number  of  women  and  infants 
shall  be  cared  for  at  one  time  on  such  premises 
than  is  authorized  by  the  license  and  no  women 
or  infants  shall  be  kept  in  a  building  or  place 
not  designated  in  the  license. 

• 


Physical  equipment. 

1.  All    rooms    occupied   by   patients   shall    be 
outside  rooms  and  the  window  space  shall  not* 
be  less  than  one-fifth  of  the  floor  space. 

2.  The    rooms   shall    be   of   sufficient   size    to 
allow  not  less  than  800  cu.  ft.  of  air  space  and 
100  sq.  ft.  of  floor  space  for  each  adult  patient 
and   250  cu.   ft.   of   air   space   for   each   infant 
therein.     Ventilation   shall    conform   with   state 
housing  laws. 

3.  All  plumbing,  drainage  and  other  arrange- 
ments for  the  disposal  of  excreta  and  household 
waste  shall  be  in  accordance  with  the  rules  and 
n '-illations  of  the  State   Board  of  Health  and 
local  health  ordinances. 

4.  Toilets  and  hoppers  shall  be  properly  and 
adequately  ventilated  to  the  external  air. 

5.  In  order  that  the  heating  of  all  rooms  shall 
be  safe  and  adequate  no  gas  stove  shall  be  used 
which  is  not  directly  connected  with  an  outside 
flue  and  all  gas  connections  should  be  of  metal 
piping. 

6.  Fire  protection   shall   be   according  to  the 
rules  and  regulations  of  the  local  fire  commis- 
sion or  city  ordinance  and  the  rules  and  regula- 
tions   of    the    State    Board    of    Charities    and 
Corrections.     These  standards  will  be  furnished 
with  the  application. 

7.  There    shall    be    sanitary    equipment    for 
thorough  bathing  of  patients  and  infants. 

8.  An  adequate  supply  of  clean  bedding,  body 
linen  and  towels  shall  be  kept  on  hand  at  all 
times. 

A  separate  bed  pan  marked  for  use  of  indi- 
vidual patients  is  strongly  advocated. 

The  following  equipment  shall  be  provided: 

For  delivery. 

1.  Suitable  table  or  hospital  bed  for  delivery. 

2.  At  least  three  pitchers. 

3.  Two  basins. 

4.  Two  tubs  or  large  basins  for  resuscitation. 

5.  One  pail  for  waste  material. 

14 


6.  Ample  supply  of  sterile  dressings,   towels, 
leggings,  sheets. 

7.  Two   nail   brushes   for   doctor's   use    only; 
should  be  boiled  before  and  after  using  and  kept 
in  a  weak  solution  of  bichloride  of  mercury,  or 
lysol,  in  a  glass  jar. 

8.  All  linen  should  be  marked  and  kept  sepa- 
rate for  patients. 

9.  Wooden  blocks  4?  and   6  inches  high  shall 
be    provided    for    use    in    case    of    hemorrhage, 
where  surgical  bed  is  not  in  use. 

10.  At  the  time  of  delivery  plenty  of  hot  and 
cold  sterile  water  (boiled  for  20  minutes). 

11.  Facilities  for  sterilizing  instruments  shall 
be  provided. 

12.  The   following  supplies   are   recommended 
to  be  kept  on  hand :  Fl.  extract  of  ergot,  lysol, 
bichloride  tablets    (blue),  sterile  cord  tape  and 
blunt  scissors,  nitrate  of  silver  (1%),  or  argyrol, 
two  pieces  of  linen  tape. 

For  infant. 

1.  Separate  cribs  or  baskets  for  babies — clean 
mattresses  covered  with  rubber  sheeting  and 
clean  flannel  blankets  are  to  be  used. 

»2.  Correct  scales  for  weighing  infants. 
3.  Nitrate  of  silver  one  per  cent  solution. 

4*.  A  tray  or  basket  equipped  with  necessary 
articles  to  be  used  in  dressing  and  caring  for 
infants ;  to  contain  sterile  gauze,  absorbent  cot- 
ton, medium  and  small  safety  pins,  cotton  appli- 
cators, bottle  of  alcohol,  a  bar  of  pure  mild  soap, 
a  proper  lubricant  (albolene  or  olive  oil),  boric 
acid  solution,  pure  powder,  abdominal  binder  for 
infant. 

5.  If  hot  water  bags  are  ordered  by  physician 
they  must  be  covered  with  a  flannel  bag  before 
being  placed  in  the  crib,  and  must  not  come  in 
direct  contact  with  the  baby's  body. 

().  All  nursing  bottles  and  nipples  must  be 
boiled  at  least  once  a  day,  and  individual  nipples 
must  be  provided  for  each  child. 

15 


For  mother. 

1.  Clean    piece    of    rubber    sheeting   for    each 
patient's  bed. 

2.  Individual  bed  pans  marked  with  name  of 
patient. 

3.  Metal   douche  cans  instead  of  rubber  irri- 
gating bags. 

4.  Glass  tips  and  nozzles — to  be  boiled  before 
and  after  using  and  kept  in  lysol  solution. 

5.  Clinical    thermometers ;    to    be    washed    in 
alcohol  before  and  after  using. 

Care  of  patients. 

1.  This  board  urges  the  attendance  of  a  legally 
qualified  physician  at  all  confinements.     The  law 
permits  midwifes  to  assist  women  only  in  cases 
of  normal  child  birth.      (See  Statutes  1917,  Sec. 
8,   page   1)6.)      In    any   but    a   normal   case   the 
midwife  must  immediately  call  a  legally  qualified 
physician. 

2.  The  eyes  of  all  new  born  infants  shall  be 
treated  immediately  after  birth  with  a  one  per 
cent  solution  of  nitrate  of  silver,  two  drops  in 
each   eye,   or  with  other  approved  solution   and 
during   the  first   few   days   cleansed   daily   with 
saturated  boric  acid  solution.     Ampoules  of  ni- 
trate of  silver  solution  may  be  obtained  free  of 
charge  by  charitable  institutions  upon  applica- 
tion to  State  Board  of  Health,  713  Wells  Fargo 
Building,  San  Francisco,  or  821  Pacific  Finance 
Building,  Los  Angeles. 

3.  Attention   is   called   to  Chapter  724,    Stat- 
utes 1915,  which  requires  the  reporting  of  red- 
dened   or    inflamed    eyes    of    an    infant,    within 
two  weeks  after  birth,  to  the  local  health  officer 
of  the  county  or  municipality  within  which  the 
mother  of  such  infant  resides. 

4.  If   the   child  is   kept   in   the   home    and   is 
not  breast  fed  by  the  mother,   the  feeding  and 
selection  of  food,  shall  be  under  the  direction  of 
a   registered-  physician.     If  a  wet-nurse  is  pro- 
vided,    she    shall    meet    the    approval    of    the 
physician.     Whenever  advisable  the  mother  shall 
be  urged  to  nurse  her  child. 

16 


5.  Any  patients  afflicted  with  a  venereal  or 
other  communicable  disease  shall  be  properly 
isolated  in  a  separate  room  and  all  necessary 
precautions  taken  to  prevent  the  spread  of  such 
disease  to  other  persons. 

Disposal   of  child. 

1.  Attention   is   called   to   section   224   of   the 
Civil  Code  in  accordance  with  which  a  child  not 
retained     by     the     mother     must     be     legally 
relinquished    before    it    can    be    adopted.     This 
relinquishment    must    be    expressed    in    writing, 
signed     and     acknowledged     before     an     officer 
authorized   to   take   acknowledgments,   or  before 
the  secretary  of  one  of  the  organizations  men- 
tioned below.     Before  adoption  can  take  place  a 
copy  of  the  relinquishment  must  be   filed  writh 
the  State  Board  of  Charities  and  Corrections. 

2.  Attention   is   called   to  Chapter   569,    Stat- 
utes   1911,    providing    for    the    supervision    and 
control    of    the    State    Board    of    Charities    and 
Corrections  of  the  placing  of  dependent  children 
into  homes,  which  makes  it  a  misdemeanor  for 
any  person,  association  or  society  to  engage  in 
the  work  of  placing  children  into  homes  without 
a  license  from  the  State  Board  of  Charities  and 
Corrections.     The  following  agencies  have  been 
licensed  to  place  dependent  children  into  homes 
and  to  arrange  for  adoption  : 

Berkeley  Welfare  Society,  2120  Grove  street, 
Berkeley. 

Children's  Home  Society,  919  E.  Twenty-fifth 
street,  Los  Angeles. 

Children's  Home  Society  (Branch),  3491 
Sixty-sixth  street,  Oakland. 

Catholic  Ladies'  Aid  Society,  City  Hall,  Oak- 
land. 

Oakland  Associated  Charities,  City  Hall,  Oak- 
land. 

Little  Children's  Aid,  995  Market  street,  San 
Francisco. 


17 


Children's  Agency  of  the  Associated  Chari- 
ties, 1500  Jackson  street,  San  Francisco. 

Eureka  Benevolent  Society,  436  O'Farrell 
street,  San  Francisco. 

Native  Sons'  and  Daughters'  Central  Com- 
mittee on  Homeless  Children,  955  Phelan  Build- 
ing, San  Francisco,  322  N.  Van  Ness  avenue,  Los 
Angeles. 

3.  Each    licensee    shall    use   due   diligence   to 
prevent  the  abandonment  of  the  children,  which 
is,  according  to  sections  270-271  and  271a  of  the 
Penal  Code,  a  penal  offense. 

4.  A  licensee  shall  not  be  permitted  to  adver- 
tise that  he  will  procure  the  adoption  of  children 
or  to  hold  out  inducements  to  mothers  to  part 
with  their  offspring. 

5.  Maternity    hospitals    and    homes   shall    re- 
port  on    the    usual    report    forms    to   the   State 
Board    of     Charities     and     Corrections    within 
twenty-four  hours  the  name  and  address  of  any 
person  other  than  a  parent  or  relative  by  blood 
or   marriage,    or   the  name   and   address   of   the 
organization   or  institution   into   whose   custody 
a  child  is  given  on  discharge  from  the  licensed 
premises. 

Records. 

1.  Every  licensee  must  have  a  register 
wherein  he  shall  enter  the  name  and  address  of 
every  maternity  patient,  the  date  of  admission 
and  discharge  of  every  patient,  the  name  and 
sex  of  every  child  born  or  boarded  on  the 
^premises,  the  date  of  every  birth,  the  legitimacy 
or  illegitimacy  of  every  child,  the  name  and  resi- 
dence of  the  father,  the  date  of  removal  of  the 
child',  the  name  and  address  of  the  person  taking 
it  away,  and,  if  relinquished  by  the  mother,  the 
date  of  relinquishment,  the  name  and  address 
of  the  person  to  wrhom  the  child  is  relinquished, 
and  the  reasons  therefor ;  and  if  adopted,  the 
date  of  adoption,  the  name  of  the  person  sign- 
ing the  consent  of  adoption,  and  the  name  and 


18 


Iress  of  the  person  adopting  the  child. 
Every  admission,  discharge,  birth,  death,  relin- 
quishment  or  adoption  must  be  recorded  in  the 
register  within  twenty-four  hours  after  its 
occurrence.* 

2.  A   semi-annual   report,   which  shall   be   an 
exact   transcript  of  this  register,  shall  be  made 
to  the  State  Board  of  Charities  and  Corrections, 
995   Market  street,    San   Francisco,   January  1 
and  July  1  of  each  year. 

3.  A  detailed  medical  record  of  mothers'  and 
infants'  physical  condition  shall  be  maintained. 
(Sample    forms    provided    by    State    Board    of 
Charities  and  Corrections,  upon  request.) 

4.  It    is    recommended    that   all    orders   from 
physicians    regarding    mothers    and    infants    be 
written  in  ink  on  charts  or  in  order  book. 

5.  It  is  recommended  that  attending  physician 
jxaniine  mother  and  infant  on  day  of  discharge 
md  attach  signature  to  statement  of  findings. 

6.  All    births    and    deaths    must    be   reported 
promptly  to  the  local  authorities  by  the  attend- 
ing physician.      ( See  Political  Code,  Section  3077, 
Chapter  378,  Statutes  1915.) 

*The  State  Board  of  Charities  and  Corrections 
does  not  furnish  the  maternity  hospital  regis- 
ter, it  merely  prescribes  the  form.  A  book  may 
be  obtained  from  A.  Carlisle  and  Co.,  251  Bush 
street,  Schwabacher,  Frey  and  Company,  611 
Market  street,  or  H.  S.  Crocker,  565  Market 
street,  San  Francisco,  and  from  Morris  and  Le 
Leviere,  218  New  High  street,  Los  Angeles. 
These  forms  are  kept  in  duplicate,  the  per- 
forated sheets  to  be  removed  and  sent  to  the 
office  of  the  State  Board  of  Charities  and  Cor- 
rections, as  the  semi-annual  report.  The  car- 
bon copy  remains  permanently  bound  for  the 
hospital  record. 


I 


19 


Inspection. 

The  proprietor  or  person  in  charge  of 
maternity  home  shall  give  the  inspectors  of  thl 
State  Board  of  Charities  and  Corrections  af 
information  required  and  shall  afford  them  ever] 
facility  for  examining  the  records,  inspecting 
the  premises,  and  seeing  the  inmates,  and  inquir] 
ing  into  all  matters  concerning  such  home 
house  and  the  inmates  thereof. 


21117   9-22   IM 


20 


1UAK.C1 1 

rracuse,  [ 

PAT.J 


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